YUG-17524-62400

4 vaccinations 8 coded responses 44 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 480 / MI
Registered: 2021-01-05

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-01-06
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-07
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-01
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness · Headache, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Flushing, Immediate post-injection reaction, Rash, Rash macular — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Rash is red blotches on face. Appeared about 30 minutes after injection and flushing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Facial bright red rash areas have not gone away from 1st day of vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Hypersensitivity, Pre-existing disease, Rash macular — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Facial red blotches, have not gone away since day 1. Looks like a lupus flare and/ or allergic reaction I have had in past to a drug.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash macular — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Big Facial red blotches and rash from day one have not gone away!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-12
Health check-in — day 7, dose 3
Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-26
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-03
Survey response — day 28, dose 3
MedDRA: Arthralgia, Ligament pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint and ligament pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-17
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-06
Survey response — 3 months, dose 3
MedDRA: Breast cancer — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Breast cancer

MedDRA releases: 2024-11 · check-in free text available
2022-02-06
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-11
Call 1 — Left Voicemail
2022-03-31
Dose 4 — Moderna
2022-03-31
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2022-04-01
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-02
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2022-04-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2022-04-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2022-04-08
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-14
Survey response — day 14, dose 4
MedDRA: Chest pain, Pleural effusion, Therapeutic aspiration, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Chronic pain in chest, Fluid buildup, aspiration left breast/chest · Healthcare visit (other): CT scan

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Report sent to call center — day 14, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-19
Call successful
Does not wish to fill out VAERS report
2022-04-21
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-04-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-31
Survey response — 12 months, dose 4
MedDRA: Breast cancer, Electrocardiogram QT prolonged — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

MedDRA releases: 2024-11
2023-03-31
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2023-04-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-01	Moderna
3	2021-11-05	Moderna	No
4	2022-03-31	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-06	priority 2/3
2021-01-07	priority 2/3
2022-02-06	Successful	Does not wish to fill out VAERS report
2022-04-14	Successful 2022-04-19	Does not wish to fill out VAERS report
2023-03-31	Successful 2023-04-03	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-02

Systemic reaction (other): Rash is red blotches on face. Appeared about 30 minutes after injection and flushing.

2021-02-03

Systemic reaction (other): Facial bright red rash areas have not gone away from 1st day of vaccine

2021-02-04

Systemic reaction (other): Facial red blotches, have not gone away since day 1. Looks like a lupus flare and/ or allergic reaction I have had in past to a drug.

2021-02-05

Systemic reaction (other): Big Facial red blotches and rash from day one have not gone away!

Release 10 — day 28, dose 3

2021-12-03

Symptoms: Joint and ligament pain

Release 11 — 3 months, dose 3

2022-02-06

Symptoms: Breast cancer

Release 11 — day 14, dose 4

2022-04-14

Symptoms: Chronic pain in chest, Fluid buildup, aspiration left breast/chest

Healthcare visit (other): CT scan

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Breast cancer	·	·	✓
SD	Chest pain	·	·	✓
SD	Electrocardiogram QT prolonged	·	·	✓
SD	Ligament pain	·	·	✓
SD	Pleural effusion	·	·	✓
SD	Therapeutic aspiration	·	·	✓
SRO	Erythema	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash macular	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release